The COVID-19 pandemic has significantly shifted the payer mix and will likely directly impact a healthcare organization’s ability to recover revenue from missed insurance discovery opportunities. As of early May, an estimated 27 million patients may have seen disruptions or a cease in their employer-sponsored insurance due to unemployment.1 And with the national unemployment rate hitting a high of 14.7% as of April 20202— equating to almost 41 million unemployed persons at the end of May3 — it’ll be critical for organizations to identify COVID-19 patients who were or are now unexpectedly uninsured. This isn’t likely a problem that’s going to go away anytime soon, and it’ll be important for healthcare organizations to be prepared.
In early April, the U.S. Department of Health & Human Services (HHS) announced a portion of the Provider Relief Fund in the Coronavirus Aid, Relief, and Economic Security (CARES) Act4 will be used to reimburse healthcare providers (at Medicare rates) for COVID-19-related treatment of the uninsured. Subject to available funding, every healthcare provider who has provided treatment for uninsured COVID-19 patients on or after Feb. 4, 2020, can request claims reimbursement through the program. Validating the lack of insurance coverage is critical for seeking these funds. TransUnion Healthcare is offering its insurance discovery clients access to a detailed report of their uninsured COVID-19 patients to help them better realize these funds.
As many providers have experienced significant revenue shortfalls due to reduced and cancelled elective procedures, ensuring the highest reimbursement rates are realized — for insured and uninsured patients — is imperative. Here are some tips healthcare providers should consider as they look for additional payment opportunities:
Utilize internal or external resources to reconfirm insurance coverage information. Keep in mind, while your staff efforts can capture missed coverage opportunities (up to 90% in most cases), an external partner can find additional, complex payments.
Confirm patient contact information is up to date. This will make it easier to engage patients, find coverage and optimize collections.
Look beyond self-pay accounts, including potential coordination of benefits opportunities and Medicaid secondary coverage.
Leverage a self-service, patient-facing payment tool to encourage customized collection plans based on unique needs. This enables you to better engage patients and be sensitive to their financial situation.
How TransUnion Healthcare is helping clients capture revenue during the pandemic
TransUnion Healthcare is using our industry-leading Insurance Discovery solution to find potential existing coverage for COVID-19 patients so providers can be appropriately reimbursed by a third-party. Equally as important, we’ve created a report to identify COVID-19 patients where we cannot identify active insurance coverage. Automating the insurance validation process will help expedite reimbursements and add an extra layer of audit documentation in future periods. The report outlining uninsured COVID-19 patients is being offered complimentary to all our insurance discovery clients, thus enhancing ease of submitting reimbursement claims via the Health Resources & Services Administration (HRSA) website.
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